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### Question: Who is at highest risk for Ependymoma ?
### Response: Children with certain hereditary diseases, such as neurofibromatosis type II (NF2), Turcot syndrome B, and MEN1 syndrome, have been found to be more frequently afflicted with ependymal tumors.
Increased occurrence of chromosome 1q and proteins such as tenascin C and epidermal growth factor are associated with increased risk for developing ependymal tumors. ERBB2, ERBB4, and human telomerase reverse transcriptase TERT gene expression promote tumor cell proliferation, contributing to aggressive tumor behavior. High expression of epidermal growth factor receptor EGFR correlates with unfavorable outcome. Over-expression of kinetochore proteins and down-regulation of metallothioneins are associated with recurrence of ependymomas.